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78 Cards in this Set
- Front
- Back
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What is Pelvic Inflammatory Disease (PID)
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inflammation of pelvic and adnexal structures
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what are 4 potential causes of PID?
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1. STD's (gonorrhea, clamydia)
2. post-surgical abcess formation 3. IUD's 4. instrament invastion into the endo. |
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Why would IUD's potentiallly cause PID
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Because there is string which remains thru the cervix after insertion. bacteria can enter into the endo thru the cervix
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What percent of PID is caused by STD's
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85%
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what type of proceedure could be done that would cause an instrament insertion into the endo
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sonohystogram
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What are 5 risk factors for developing PID?
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1. early sexual contact
2. multiple sexual partners 3. hx of STD 4. douching 5. menstrating women |
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why would douching increase your risk for PID
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takes away bacteria normally found in the vagina
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what percent of women of reproductive age have been dx with PID
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10%
1 million each year |
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what are 6 possible symptoms of PID
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1. intense pelvic pain
2. vaginal discharge 3. abnormal bleeding 4. palpable adnexal mass 5. elevated WBC 6. febrile |
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what % of ppl with PID have vag. discharge as a symptom?
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75%
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what % of ppl with PID have abnormal bleeding as a symptom?
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35%
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what % of ppl w/ PID are febrile?
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30%
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What are 6 possible sonographic appearances of someone with PID?
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1. collection of FF/ pus in pelvic cavity.
2. abscess 3. endometritis 4. salpingitis 5. enlarged ovaries (oophoritis) 6. TOA |
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what does TOA stand for>
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tubo-ovarian absess
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Appearance of PID will vary with ______________ and ____________ of infection.
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duration and severity
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How is PID spread?
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thru fluid surrounding pelvic organs
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what is the route of transmittal
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cervix, endo, fallopian tubes, ovaries, peritoneum
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what is the proper order of infection?
a. salpingitis, oophoritis, peritonitis, cervicitis b. endometritus, cervicitis, salpingitis, peritonitis c. cervicitis, endometritis, salpingitis, peritonitis d. pertonitis, salpingitis, endometritus, cervicitis |
c. cervicitis, endometritis, salpingitis, peritonitis
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What is the "sign" on true PID
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Chandalier Sign (jump for the chandelier)
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what are possible differential diagnosis of PID in the fallopian tubes
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salpingitis
hydrosalpinx pyosalpinx |
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what is a tubo ovarian absess (TOA)
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infection involving both tubes and ovaries
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salphingitis
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inflammation of the fallopian tube
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what causes salpingitis
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PID
endometriosis adhesions or scar tissue |
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Ashermanns Syndrome
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Scar tissue
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what are symptoms of salphingitis
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acute or chronic pain
may be asymptomatic pelvic fullness low grade fever |
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Is the normal tube typically seen on U/S
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No
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When can the fallopian tubes be seen on U/S
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1. if they are surrounded by ascites
2. filled with blood/ pus or FF |
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what are some signs of chronic PID
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loss of bowel mobility
infertility ectopic preg TOA peritonitis salpingitis |
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What causes chronic PID
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escape of puss beyond tube
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what will the ovaries look like with chronic PID
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ovaries will be enlarged, unilateral or bilateral pus in ovary
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Ovary may appear as a ______ mass, have_______ and be poorly ________.
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complex, septations, defined
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what is the treatment for chronic PID
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Antibiotic, no surgery required
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What is peritonitis
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infection of the inner lining of the abdomen
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what organs are usually involved with peritonitis
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bladder, ureters, bowel, adnexa
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are the borders of the pelvic structures well defined or poorly defined?
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poorly
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What is endometritis
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infection involving the endometrial cavity and endometrium.
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what are possible causes of endometritis
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PID, post partum infection, PROM, retained POC, invasive instraments into endo, IUD's
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What are the symptoms of endometritis
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intense pelvic pain
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What does PROM stand for?
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premature rupture of membrane
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what does POC stand for>
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products of conception
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what is the u/s appearance of endometritis
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PROM/ irregular endo
FF in endo pus/FF in culdesac enlarged ovaries dilated fallopian tubes gas bubbles increased vascularity |
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What is endometriosis
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when endometrial tissue is outside of the uterus
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what is a symptom of endometriosis
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pain when menstrating
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Where is endometriosis commonly found
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ovaries, bladder, rectum, tubes, bowel
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what brings relief for endometriosis>
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menopause
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what percent of american women experience endometriosis during repro. yrs
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7-10%
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is endometriosis hereditiary
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yes
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is endometriosis more or less common with use of BCP
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less
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what are the symptoms of endometriosis
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dysmenorrhea
dyspareunia dysurea dyschezia infertility hematuria bloody stools |
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What is diffuse endometriosis
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more common than localized and consists of endometrial plantings with in the peritoneum. difficult to se on U/s
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how do you dx diffuse endometriosis
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laproscopically
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what should you look for when evaluating for diffuse endometriosis
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mobility of all pelvic structures
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what is localized endometriosis
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focal implants of endometriosis
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what else is localized endometriosis called
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endometrioma, chocolate cysts
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where is localized endometriosis usually seen
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ovaries
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what are the symptoms of endometriosis
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asymptomatic, filled with old blood, can have ground glass appearance.
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what is the sonographic appearance of localized endometriosis
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localized low intensity internal echos with enhancement, may appear complex due to varying degrees of hemorrage
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what is adenomyosis
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localized areas of endometrial tissue (nests) with in the myometrium
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where is adenomyosis usually found
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confined to the uterus
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what are the causes of adenomyosis
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multiple pregnancies and deliveries, abnormally high estrogen levels.
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what are symptoms of adenomyosis
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dysmenorrhea, uterine enlargement, abnormal bleeding, pain thru-out menstral cycle
enlarged uterus |
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what is the u/s appearance of adenomyosis
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difficult to dx
symmetrically enlarged myometrial cysts are best u/s indicator inhomogeneous areas with myometrium |
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what is the differential dx of adenomyosis
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fibroids
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____________ & _________ often occur together
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adenomyosis and firbroids
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what is the best way to dx adenomyosis
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MRI
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IUD
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intrauterine device
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when was the IUD most widely used
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60;s and 70's
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what are the three types of IUD sold in US
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1. paragard (12 yr)
2. mirena (5) yr 3. progestasert (1yr) |
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How does Paraguard work>
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releases copper ions, effective for 12 yrs, effects PH
aka copper T |
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how does mirena work
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effective for 5 yrs, continually releases a small amt of the hormone "progesterone"
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how does progestasert work
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1yr effective, releases progestrine hormone, thickens mucous to act as a barrier for sperm
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what two IUD's are hormonal
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Mirena and progestasert
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how do IUD's work
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prevent sperm from joining an egg. if fertilization occurs, implantation is highly unlikely due to inhospitable environment; thins endo lining to prevent implant
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what do you look for when scanning an IUD
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embedding of IUD into endo
malpositoning with uterine cavity presence of iud (was it expelled) |
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what are oral contraception pills
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daily pill that contains estrogen and progestrin that prevents preg.
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endo too thick
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inadequate progesterone
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endo too thin
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inadequate prog. and estogen
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Do you usually get a dominant follicle on the pill
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no
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